Provider Demographics
NPI:1538509765
Name:RUNDEL, STEVEN CHRISTOPHER (DPT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHRISTOPHER
Last Name:RUNDEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S WOODLAWN BLVD
Mailing Address - Street 2:#406
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-3618
Mailing Address - Country:US
Mailing Address - Phone:316-655-2570
Mailing Address - Fax:316-691-5304
Practice Address - Street 1:4300 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2119
Practice Address - Country:US
Practice Address - Phone:316-945-8020
Practice Address - Fax:316-616-0106
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-03583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist